Provide a brief overview of the rationale and evidence basis behind the use of prophylactic intravenous (IV) acetylsalicylic acid (ASA) in endovascular neurological procedures. Present a 12-month single-centre experience using IV ASA in clinical practice during neurointervention.

Thromboembolic events are amongst the most common and significant complications of neurointerventional procedures. In the emergent setting, prompt administration of prophylactic antiplatelet agents is thus of utmost importance. IV ASA can reduce platelet function up to four times faster than oral formations, and also overcomes barriers to oral, nasogastric or rectal antiplatelet administration.[1] As such, IV ASA has become increasingly utilized for a variety of time-critical neurointerventional procedures, most commonly endovascular clot retrieval (ECR) and stent-assisted aneurysm coiling. IV ASA in the Treatment of Acute...

A total of 33 patients received IV ASA between October 2019 to October 2020 as part of an emergency neurointerventional procedure, including ECR, CAS, intracranial arterial stenting, angioplasty, stent-assisted coiling, and one diagnostic angiogram. Almost all patients were also given IV heparin as per institutional protocol and the neurointerventionalist’s discretion. The procedural details are summarized in Table 1. [Fig 1] Amongst the three patients who underwent stent-assisted coiling for ruptured or suspected ruptured intracranial aneurysms, all cases were technically successful and there were no peri-procedural...

There is a longstanding, growing evidence base for the use of IV ASA in neurointervention. In our single-centre 12-month consecutive case series, 33 patients received IV ASA across a variety of urgent complex neurointerventional procedures, achieving overall good technical and functional outcomes and no cases of symptomatic ICH.

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